Treating Smoking in Cancer Patients: An Essential Component of Cancer Care—The New National Cancer Institute Tobacco Control Monograph

Abstract

PURPOSE: Continued smoking after the diagnosis of cancer can markedly worsen oncology treatment side effects, cancer outcomes, cancer mortality, and all-cause mortality. Conversely, mounting evidence demonstrates that smoking cessation by patients with cancer improves outcomes. A cancer diagnosis often serves as a teachable moment, characterized by high motivation to quit. However, too few patients with cancer who smoke are offered evidence-based smoking cessation treatment, and too few engage in such treatment. METHODS AND MATERIALS: The National Cancer Institute commissioned Tobacco Control Monograph 23, Treating Smoking in Cancer Patients: An Essential Component of Cancer Care, to review and synthesize the evidence that clarifies the need to intervene with smoking in cancer care. RESULTS: Although many patients with newly diagnosed cancer who smoke make quit attempts, many of these are unsuccessful, and among those who successfully quit, relapse is common. Indeed, an estimated 12.2% of adults ever diagnosed with cancer reported they currently smoked (National Health Interview Survey, 2020). Patients with cancer who smoke are likely to benefit from smoking cessation treatments, including counseling and US Food and Drug Administration–approved medications, and there are many effective strategies to increase delivery of smoking cessation treatment in cancer care settings. CONCLUSION: Smoking cessation is among the most effective treatment options for improving the likelihood of survival, quality of life, and overall health of patients with cancer who smoke. It is important for cancer care clinicians and patients to realize that it is never too late to quit smoking and that there are clear benefits to doing so, regardless of cancer type.

Universal Tobacco Screening and Opt-Out Treatment Referral Strategy Among Patients Diagnosed With Cancer by Race and Ethnicity

“…These findings suggest that a standardized tobacco use assessment with opt-out referral to tobacco treatment in a large cancer care setting is feasible and achieves higher tobacco treatment referral and acceptance rates than typically observed . By normalizing tobacco use screening and treatment as essential elements of high-quality cancer care, a universal tobacco screening and opt-out referral strategy may mitigate the stigma associated with patient engagement in tobacco treatment . An opt-out referral model may eliminate clinician referral bias and thereby facilitate equitable access to and use of tobacco treatment services among racially and ethnically diverse patients with cancer.…”

Cancer survival in sub-Saharan Africa (SURVCAN-3): a population-based study

“…Tobacco use, which is more common among males than females, might explain the poorer survival observed among males with stomach or lung cancer. 26 Differences in cancer survival by ethnicity in Zimbabwe could be explained by the fact that the follow-up of registered cancer cases in Harare showed that many hospital admissions among the white population were to the private sector, with probable better access to care.…”

The STOP Program: a Hybrid Smoking Prevention and Cessation Training for Cancer Care Providers in Colombia and Peru

“…Continued smoking after a cancer diagnosis has been linked with shorter survival, recurrent disease, decreased treatment efficacy, and reduced quality of life [1]. In the United States (US) and other high-income countries, a cancer diagnosis has been used as a window of opportunity to intervene and provide smoking prevention and cessation assistance to patients and survivors [2,3]. Findings from Irene Tamí-Maury and Samuel Tundealao are joint first authors and contributed equally to this work.…”